Low Educational Background Research Articles

A Pre-Post Study on the Appropriateness and Effectiveness of a Web- and Text Messaging-Based Intervention to Reduce Problem Drinking in Emerging Adults

BackgroundProblem drinking, particularly risky single-occasion drinking (RSOD), also called “binge drinking”, is widespread among adolescents and young adults in most Western countries. Few studies have tested the effectiveness of interventions to reduce RSOD in young people with heterogeneous and particularly lower educational background.ObjectiveTo test the appropriateness and initial effectiveness of a combined, individually tailored Web- and text messaging (SMS)–based intervention program to reduce problem drinking in vocational school students.MethodsThe fully automated program provided: (1) online feedback about an individual’s drinking pattern compared to the drinking norms of an age- and gender-specific reference group, and (2) recurrent individualized SMS messages over a time period of 3 months. Generalized Estimating Equation (GEE) analyses were used to investigate the longitudinal courses of the following outcomes over the study period of 3 months: RSOD, alcohol-related problems, mean number of standard drinks per week, and maximum number of standard drinks on an occasion.ResultsThe program was tested in 36 school classes at 7 vocational schools in Switzerland. Regardless of their drinking behavior, 477 vocational school students who owned a mobile phone were invited to participate in the program. Of these, 364 (76.3%) participated in the program. During the intervention period, 23 out of 364 (6.3%) persons unsubscribed from participating in the program. The GEE analyses revealed decreases in the percentage of persons with RSOD from baseline (75.5%, 210/278) to follow-up assessment (67.6%, 188/278, P<.001), in the percentage of persons with alcohol-related problems (20.4%, 57/280 to 14.3%, 40/280, P=.009), and in the mean number of standard drinks per week: 13.4 (SD 15.3) to 11.3 (SD 14.0), P=.002. They also revealed a trend toward a decrease in the mean of the maximum number of drinks consumed on an occasion: 11.3 (SD 10.3) to 10.5 (SD 10.3), P=.08.ConclusionsThe results show high acceptance and promising effectiveness of this interventional approach, which could be easily and economically implemented within school classes.

The effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among adolescents aged 15–20 years with a low educational background: a two-arm parallel group cluster randomized controlled trial

BackgroundTo evaluate the slightly modified version of the web-based brief alcohol intervention “What Do You Drink” (WDYD) among heavy drinking adolescents and young adults aged 15–20 years with a low educational background at one and six months follow-up.MethodsA two-arm parallel group cluster randomized controlled trial was conducted online in the Netherlands in 2011–2012. Participants included in the trial were recruited from preparatory and secondary vocational education institutions and had to be between 15 and 20 years of age and report heavy drinking in the past six months. In total, 73 classes representing 609 (59.9% male) participants were allocated to the experimental condition (37 classes, 318 participants: WDYD intervention) or control condition (36 classes, 291 participants: no intervention). Outcomes were heavy drinking, weekly alcohol consumption, and frequency of binge drinking.ResultsRegressions analyses revealed no significant main intervention effects on any of the alcohol outcomes at one and six month’s follow-up according to the intention-to-treat principle. Additionally, there were no moderating effects of gender, age, educational level, and readiness to change on the relation between the WDYD intervention and the alcohol outcomes at follow-up.ConclusionsThe WDYD intervention was not effective in reducing alcohol consumption among heavy drinking adolescents and young adults aged 15–20 years with a low educational background at one and six months follow-up. However, the absence of intervention effectiveness cannot be used as an argument for not conducting these types of interventions with low educated individuals, since our study was the first to target this population.Trial registrationNetherlands Trial Register NTR2971

Honor Killing Attitudes Amongst Adolescents in Amman, Jordan

The present study examines attitudes towards honor crimes amongst a sample of 856 ninth grade students (mean age = 14.6, SD = 0.56) from 14 schools in Amman, Jordan. Descriptive findings suggest that about 40% of boys and 20% of girls believe that killing a daughter, sister, or wife who has dishonored the family can be justified. A number of theoretically meaningful predictors were examined: Findings suggest that attitudes in support of honor killings are more likely amongst adolescents who have collectivist and patriarchal world views, believe in the importance of female chastity amongst adolescents, and morally neutralize aggressive behavior in general. Findings for parental harsh discipline are mixed: While the father's harsh discipline is predictive of honor killing attitudes, the mother's behavior is not. Furthermore, support for honor killing is stronger amongst male adolescents and adolescents for low education backgrounds. After controlling for other factors religion and the intensity of religious beliefs are not associated with support for honor killings. Models were tested separately for male and female respondents and suggested no systematic differences in predictors. Limitations and implications are discussed.

Planning and Execution of Diabetes Awareness and Screening Camp in an Educational Institution

Diabetes has emerged as a major healthcare issue in India and is projected that every fifth diabetic person will be an Indian by 2030. In developing countries like India this problem is further compounded by rapid urbanization and associated increase in stress and diabetes. A one day diabetes awareness screening camp was conducted in an educational institute situated in a rural area. A complete participant history was obtained and parameters like blood pressure, random blood sugar (RBS), and body mass index were evaluated Each participant was individually counselled on signs, symptoms, prevention and management of diabetes with appropriate educational material. A higher mean RBS level was noted in smokers, older participants, in known diabetics and in participants with a family history of diabetes. Additionally, a higher average RBS was noted in low family income group and in participants with low educational background. Awareness of symptoms, knowledge of prevention and management of diabetes are important for dealing with this worldwide burden of diabetes. This study was small but successful attempt to spread the awareness and education on diabetes.

Estudantes de graduação em saúde coletiva: perfil sociodemográfico e motivações

Undergraduate Courses in Public Health (UCPH) feature a new way of teaching in the Public Health field that aims to educate professionals focused on the main health needs of the Brazilian population and on the Unified Health System. Thus, it is relevant to know the students' socio-demographic profile including their interests in relation to education and professional development. Adopting a quantitative approach with these objectives, a survey was conducted with 304 UCPH students who filled out a semi-structured questionnaire in 2010 in the following federal universities: Acre, Bahia, Minas Gerais, Mato Grosso, Paraná, Rio de Janeiro and Rio Grande do Norte. The overwhelming majority was female, around 26 years of age, single, living with their parents, mostly attended public school, came from lower classes with lower educational background, approved night classes, worked, and contributed to their family incomes. They aspired to work in public sector - preferably in the state capitals - and they saw UCPH as an opportunity to work in the public health field. This profile reveals challenges and advances in the intended education, reinforcing the need to monitor the UCPH development process.

Hypoglycemic drug adjustment and other factors related to reaching target glucose in type 2 diabetic patients under community management: Beijing Community Diabetes Study 9

Objective To analyze the impact of antidiabetic drugs adjustment and other related factors on reaching target glucose in type 2 diabetic patients under community management. Methods Total 3201 patients with type 2 diabetes from 15 community health service centers in Beijing were enrolled in the study, who entered the community diabeta management program from August 2008 to July 2011. According to the glucose-lowering drugs adjustment during 3 years intervention period, patients were divided into 4 groups: 255 patients (8.0%) in insulin-added group, 641 (20.0%) in oral hypoglycemic drugs-added(OHA)group, 1621 (50.6%) in hypoglycemic drug-constant group and 684 (21.4%) in drug-reduced group. Results The hemoglobin A1c(HbA1c) levels were reduced from(8.3±1.9)%, (7.4±1.7)%, (6.8±1.3)% and(7.2±1.5)% to (7.5±1.5)% (t=5.38, P 0.05), respectively in above 4 groups after 3 years management; the rates of HbA1c-reduction>0.5% unit were 52.2%(133/255), 34.3%(220/641), 24.6%(399/1621) and 31.9%(218/684), respectively. In 562(43.9%)out of 1280 cases whose HbA1c≥7% before entering the management program, the HbA1c levels reached to <7.0%(P<0.01); the rate of reaching recommended target of HbA1c(48.4%) was significantly higher in OHA group than that of other 3 groups. After 3 years management the blood glucose control rates in patients with low, middle and high educational backgrounds were 61.5%(342/556), 64.7% (1174/1814)and 74.5%(619/813); those in patients with low, middle and high economic levels were 58.1%(971/1670), 77.3%(828/1071) and 66.8%(137/205), respectively(P<0.01). Multivariant logistic regression analysis showed that adding insulin, adding OHA, per capita income ￥2000-4000/M, BMI reduction during management period and age of patients were independent related factors for decrease in HbA1c, with odds ratio (OR) of 0.45, 0.80, 0.72, 0.96 and 1.08(P<0.05). Conclusion By management of hypoglycemic drugs actively, patients with type 2 diabetes in Beijing communities show significant improvement in HbA1c levels from 2008 to 2011, but the low educational back ground and low-income groups still should be the primary focus. Key words: Community health services; Diabetes mellitus, type 2; Glycosylated hemoglobin; Antidiabetic agents

Association between maternal education and diet of children at 9 months is partially explained by mothers' diet

Infants of mothers of low educational background display consistently poorer outcomes, including suboptimal weaning diets. Less is known about the different causal pathways that relate maternal education to infants' diet. The present study aimed to test the hypothesis that the relationship between maternal education and infants' diet is mediated by mothers' diet. The analyses included 421 mother-infant pairs from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program. Dietary intakes were collected from mothers when infants were aged 3 months, using a validated food frequency questionnaire relating to the past year, and in infants aged 9 months using 3 × 24-h recalls. Principal component analysis was used to derive dietary pattern scores, based on frequencies of 55 food groups in mothers, and intakes of 23 food groups in infants. Associations were assessed with multivariable linear regression. We tested the product 'ab' to address the mediation hypothesis, where 'a' refers to the relationship between the predictor variable (education) and the mediator variable (mothers' diet), and 'b' refers to the association between the mediator variable and the outcome variable (infants' diet), controlling for the predictor variable. Maternal scores on the 'Fruit and vegetables' dietary pattern partially mediated the relationships between maternal education and two infant dietary patterns, namely 'Balanced weaning diet' [ab = 0.11; 95% confidence interval (CI): 0.04; 0.18] and 'Formula' (ab = -0.08; 95%CI: -0.15; -0.02). These findings suggest that targeting pregnant mothers of low education level with the aim of improving their own diet may also promote better weaning diets in their infants.

The Current Development Status Analysis of Medical Record Department of 50 Hospitals in Jilin Province

AbstractObjective. To investigate the current development status of medical record department, then provide basis for improving the medical record department in 50 Hospitals in Jilin Province. Method. To issue questionnaires to medical record departments of 50 hospitals in Jilin Province by means of random sampling method. The questionnaires are sent through electronic mail, and the heads of the departments are invited to fill them. Results. The configuration structure of Jilin Province medical record departments’ employees is irrational, females account for 83.19%, age focus is above 30 years accounting for 85.43% with relatively low educational background. In aspects of professional background, employees who are majored in clinical medicine and nursing account for 54.88%. Hospital preparation bed spaces and medical record administrative staff account for 92%, proportioning to over 50:1. In addition, the relationship of administrative subordination in medical record department is unreasonable, and job fu...

Trends in postpartum maternal morbidity in Ikot Ekpene a rural community in Southern Nigeria

Background: Postpartum maternal morbidity is becoming a major public health concern worldwide due to impact of modern development in feto-maternal medicine and maternal care. Major acute and long term maternal morbidities which may occur during obstetric management affect the life and reproductive career of women. Objective: To assess the trends, risk factors and pattern of postpartum maternal morbidity in Ikot Ekpene a local community in southern Nigeria. Materials and Methods: This was a 4-year prospective cross sectional observational study carried out in the maternity section of General Hospital Ikot Ekpene, Akwa Ibom State, Nigeria between 2008 and 2011. Parturients managed in the hospital for postpartum morbidity were recruited for the study. Relevant information was obtained from structured questionnaire administered to the patients and those extracted from other medical records in the course of managing the patients. This was analysed using the SPSS computer statistical package. Result: A total of 5760 women delivered during the period, of which 296 (5.1%) were treated for postpartum morbidity. Most of the patients (46.9%) were between 31 and 40 years old and 68.8% were of low educational background. Half of the deliveries with morbidity were conducted by unskilled attendants. The most common maternal morbidity encountered included primary postpartum haemorrhage (22.2%), genital sepsis (16.1%), and hypertensive disorders (12.8%). Anaemia (12.8%) and malaria (11.1%) were the commonest non obstetrics causes of morbidity. It was relatively more common with delivery attended by untrained personnel. There was significant reduction in morbidity in the last 2 years of this study. Conclusion: The incidence of postpartum morbidity in the Ikot Ekpene is still high with a downward trend over the years. Obstetric haemorrhage, hypertensive disorders, anaemia and genital tract sepsis were the common causes and were commoner with delivery attended by unskilled personnel. It is hoped that supervision of deliveries by skilled medical attendants, improvement in general health and educational level will reduce postpartum morbidity in this rural community.

A survey on the current status of burn rehabilitation services in China

BackgroundIn China, there is a very long history of burn wound treatment, but the specialised burn care units were set up only from 1958. With more than 50 years of practice, great achievements have been made in burn wound care and operations in the country. However, in terms of burn rehabilitation, the development appears to be slow. In order to determine the current status of burn rehabilitation services in China, a survey was conducted to various burn centres in China. MethodsA comprehensive survey was conducted as well as to collect data related to (1) the admissions and staffing of the burn centres; (2) availability of rehabilitation services, number and educational background of specialised personnel dedicated in burn rehabilitation therapy; and (3) the difficulties leading to the lag of the burn rehabilitation services. The survey was sent to the chiefs of 87 burn centres via e-mail and they were requested to fill out the survey questionnaire and to send it back. For those who did not respond within 1 month, a reminder was sent. ResultsThere are totally 39 (44.8%) burn centres responding to our survey. These centres were geographically distributed in nearly 70% of the administrative provinces in China; hence, the results could well represent the current burn care system. Most centres have recognised the importance of rehabilitation therapy and remarkable improvements of outcome in burn patients have been achieved. There are a very huge number of burn patients that need rehabilitation therapy, but most centres face the problems of shortage of rehabilitation therapists, which apparently could lead to the difficulties in delivering a quality rehabilitation programme for patients. Although the time of rehabilitation therapy is instituted far earlier than before, it is still not widely accepted in the acute burn care stage. There are more specialists joining the burn centre and becoming members of the professional burn team. However, professional education and training in the burn specialty appear to be sparse. There is room for improvement. Problems that impede the progress of rehabilitation therapy are: lack of rehabilitation knowledge in medical staff as well as the public, the shortage of specialised personnel and relatively low educational background of this team, lack of standard guidelines for rehabilitation treatment instructions and lack of funding from the government. ConclusionAfter 20 years of clinical practice, rehabilitation concepts are well accepted and many forms of rehabilitation techniques are carried out in most burn centres that responded to the survey. Yet, the results also indicate that there is a short history of rehabilitation practice among the burn centres. There is a burning need to enhance the development of rehabilitation services so as to meet the demands of management of severely burned patients in China. Some suggestions are made to improve the current burn rehabilitation services which would include: (1) provide rehabilitation education programmes for burn surgeons, therapists, nurses, as well as patients, families and the public; (2) set up standard guidelines for clinical instruction of rehabilitation therapy; (3) build an interdisciplinary burn team; (4) more investigation and research on the physical and psychological outcomes of burn patients; and (5) implement administrative measures in terms of staffing, funding and offering insurance to burn survivors.

SMEs and entrepreneurial quality from a macroeconomic perspective

PurposeThe aim of this paper is to compare the particular characteristics of industrial SMEs in low‐ and high‐income regions from the perspective of their “entrepreneurial quality”.Design/methodology/approachBased on three groups of factors, (personal characteristics of entrepreneurs, entrepreneurial orientation and productive dependence of firms), which define entrepreneurial quality (EQ), the empirical analysis is focused on testing whether industrial SMEs in three Spanish regions with low per capita income present different EQs to those of industrial SMEs in three other Spanish regions with high per capita income. Data was obtained from a survey addressed to the person in the role of entrepreneur in each of these firms. Since the dependent variable is dichotomous, the logistic regression model is applied in this study.FindingsResults show there is a relationship between the regional levels of development and the entrepreneurial quality of the industrial SMEs. In low‐income regions, the level of EQ is lower due to several factors. Firstly, these entrepreneurs have lower educational background, a lack of previous experience, and are more often led by pushing motivations; secondly, these industrial SMEs have lower entrepreneurial orientation when measured through innovation and proactiveness; finally, relations between firms are characterized by a higher productive dependence.Originality/valueThis study offers a significant contribution by specifying the concept of EQ and its relationship with the degree of economic development. Likewise, a policy implication derived from the results is the need to improve the human capital of entrepreneurs in low‐income regions.

Happiness, pride and elite sporting success: What population segments gain most from national athletic achievements?

Elite sports are widely considered by national governments as a merit good through which many benefits to society as whole can be fostered through the stimulation of ‘national pride’ and ‘happiness’ (or ‘wellbeing’). The aim of this paper is to analyze what factors influence perceived national pride and happiness when athletes succeed at major national and/or international competitions. Based on a nation-wide survey, data was collected from n=2006 randomly selected Germans by means of a computer assisted telephone interview. The results reveal that 66.2% respondents felt proud and 65.6% respondents were happy when German athletes were successful at major events. National pride and happiness were significantly explained through interest in elite sports, sport participation and socio-economic variables. The results reveal that there are differences between the perception of pride and that of happiness. Women, individuals with a low educational background, and low income and individuals having a migration background are the population segments who gain most from the sporting success of elite athletes. The results show in particular that the funding of elite sports and elite athletes can be considered as policy tool for social integration.

Nutritional Knowledge and Desire to Change of Food Preferences among Saudi Women in Jeddah, Saudi Arabia

Effective nutritional education programs are based on a proper understanding of many factors, including a population's nutritional knowledge, behavior, food preferences, and a desire to change these preferences. Our study examined these variables through a convenience sample (N = 151) of adult Saudi women living in Jeddah, Saudi Arabia. Results indicated a gap between perceived and actual knowledge (p < .05) and the desire to increase intake of fruits, vegetables, and dairy products and reduce fat consumption. Taste was the main barrier for not to change. Future nutritional education programs should target women with low-education background, and the best time may be in primary school curricula.

The effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among adolescents aged 15 to 20 years with a low educational background: study protocol for a randomized controlled trial

BackgroundThe serious negative health consequences of heavy drinking among adolescents is cause for concern, especially among adolescents aged 15 to 20 years with a low educational background. In the Netherlands, there is a lack of alcohol prevention programs directed to the drinking patterns of this specific target group. The study described in this protocol will test the effectiveness of a web-based brief alcohol intervention that aims to reduce alcohol use among heavy drinking adolescents aged 15 to 20 years with a low educational background.Methods/designThe effectiveness of the What Do You Drink (WDYD) web-based brief alcohol intervention will be tested among 750 low-educated, heavy drinking adolescents. It will use a two-arm parallel group cluster randomized controlled trial. Classes of adolescents from educational institutions will be randomly assigned to either the experimental (n = 375: web-based brief alcohol intervention) or control condition (n = 375: no intervention). Primary outcomes measures will be: 1) the percentage of participants who drink within the normative limits of the Dutch National Health Council for low-risk drinking, 2) reductions in mean weekly alcohol consumption, and 3) frequency of binge drinking. The secondary outcome measures include the alcohol-related cognitions, attitudes, self-efficacy, and subjective norms, which will be measured at baseline and at one and six months after the intervention.DiscussionThis study protocol presents the study design of a two-arm parallel-group randomized controlled trial to evaluate the effectiveness of the WDYD web-based brief alcohol intervention. We hypothesized a reduction in mean weekly alcohol consumption and in the frequency of binge drinking in the experimental condition, resulting from the web-based brief alcohol intervention, compared to the control condition.Trial registrationNetherlands Trial Register NTR2971

Cigarette Use, Smoking Cessation, and Quit Intentions Among Active-Duty Military Personnel in Taiwan

This study investigates the impact of a variety of sociodemographic, behavioral, and contextual risk factors on cigarette use, abstinence success, and intentions to quit based on a survey of active-duty military personnel in Taiwan. Being male and of lower educational background increased the likelihood of tobacco use. About 80% of current smokers showed intention to quit in the immediate future, whereas stress and depression were leading causes for cigarette smoking and relapse. Other prominent predictors include attention to antismoking advertising, health concerns, social pressure, and support for a tobacco-free military. Implications for effective antismoking campaigns in the Taiwanese military are discussed.

Factors associated with mutans streptococci among young WIC‐enrolled children

The objective of this study is to assess relationships between the presence or absence of mutans streptococci (MS) and other covariates in children aged 12-49 months. Data were analyzed using baseline information from 411 children enrolled in the Special Supplemental Food Program for Women, Infants and Children (WIC) who participated in a psychoeducational study in Iowa. Children were assessed for MS using a semiquantitative method (RODAC plates). Dental examinations using d(1) d(2) .(3) criteria and presence of visible plaque on incisors and molars were completed. Mothers completed a series of detailed questionnaires regarding their child's oral health, their socioeconomic status, their child's dietary/oral hygiene habits, and beverage consumption, among other behaviors. Bivariate relationships with the presence of MS were assessed and followed by multivariable modeling using logistic regression (alpha = 0.05). MS was present in 144 children (35 percent). Bivariate relationships with MS presence were identified for multiple covariates that included demographic characteristics, type of beverage consumption, dental caries, and plaque measures. Multivariate logistic regression modeling suggested that MS presence in children was positively associated with nonwhite race of the child, number of teeth present, presence of cavitated lesions, proportion of teeth with plaque, and lower levels of maternal education. The presence of MS was associated with greater caries and plaque scores and with low maternal education and nonwhite racial background.

Gifted Students From Low-Education Backgrounds

Gifted children from low-education backgrounds often experience barriers to educational and career success. This article reviews the growing body of literature regarding gifted students from low-education backgrounds and the related literature on the challenges and characteristics of first-generation college students. A mother and daughter interview provides a contextual example of the issues identified in the literature review. Implications for educators and practitioners are suggested, including ways in which elementary and middle schools can proactively address the issues facing low-education background students in gifted programs.

Manajemen dental dalam memdokumentasikan kekerasan terhadap anak Dental management in documenting child’s abuse

Child abuse has increased dramatically over these present years. Child abuse occurs because of several reasons,such as poverty, low education background, and loss parents because of natural disasters. An estimate incidence ofchild abuse according to Komisi Nasional (Komnas) Anak in 2009 there are 1,998 cases, which is considerablyhigh. It showed that society become more consciousness about child abuse. However, there is still small evidence ofchild abuse, due to lack of awareness, knowledge and skills on documenting child abuse. Moreover, most of theinjuries of child abuse occurs at orofacial, so it is needed the awareness of dentist to understand the procedure indocumenting child abuse. The purpose of this study is to improve knowledge and skill of the dentist in documentingchild abuse.

Long‐term cognitive outcomes of extremely low‐birth‐weight infants: the influence of the maternal educational background

The purpose of the present contribution is to analyse the relationships between perinatal risk factors, social parameters and neurodevelopmental outcomes in extremely low-birth-weight (ELBW) children up to the age of 10-13 years. Of 200 live-born ELBW infants, 148 were enrolled in the high-risk infant follow-up programme. Each follow-up visit included a neurodevelopmental examination and an interview with the infant's parents. Multivariate analyses using SPSS (version 17.0, Chicago, IL, USA) were conducted, and a p-value of <0.05 indicated a statistically significant result. The results of the logistic regression analysis of the biological and sociodemographic risk factors illustrated that a low maternal educational background is the most important factor (OR, 21.9) associated with a decreased composite intelligence quotient (IQ) in children between 10 and 13 years old. A Grade III or Grade IV intraventricular haemorrhage (IVH) or periventricular leukomalacia (PVL) were also associated with decreased IQ at the age of 10-13 years (OR, 6.9). These results were confirmed by ANOVAs with repeated measurements. Maternal educational background is the strongest predictor of long-term neurodevelopment in ELBW children. The findings emphasize the need for special support and follow-up care services for poorly educated parents.

A study on delay in treatment of kala-azar patients in Bangladesh.

Visceral leishmaniasis (kala-azar) continues to be a major rural public health problem in Bangladesh. A cross-sectional study was carried out in two subdistricts of Mymensingh district from January 2006 to June 2007 to evaluate the delay kala-azar treatment. Suspected patients who attended to out patient department (OPD) were subjected to a dipstick test (RK39) for kala-azar. Sixty five from Bhaluka and 60 positive patients from Gafargaon subdistrict were enrolled. Most of the patients (80%) first visited nonqualified private practitioners, while only 15.2% consulted registered doctors. Fifty per cent were referred to the Upazilla health complex (UZHC) by the family members or relatives. About 49% and 43% patients required third and second health-care providers for kala-azar treatment, respectively. Patient delay ranged from 2 to 30 days; median 4 (IQR 3 to 7 days), the system delay ranged from 0 days to 225 days; median 54 (IQR 40-66 days). Residential status (p value <0.05) had impact on patient delay. Educational status and number of treatment providers had impact on system delay (p<0.05). System delay rather than patient delay is the important weakness of the kala-azar control programme in Bangladesh. Residence in rural areas, low educational background and treatment providers are associated with these delays. A proper educational programme may reduce the delay.